[Exhorter]

I have a question for all of you who have had your surgery. Why is it that all surgeons are different when it comes to the things they ask you to do before and after your surgery? I have read that many require then to start on a fast of liquids before the surgery to get the liver down in size. Then some do not require any change in your diet until after the surgery? Some doctors say you must take different vitamins and lots of them for the rest of your life. Some will let you have ice after your sugery and yet others will not let you. It just seems each surgeon has their own set of rules. My surgeon ask that I do nothing but start walking 30 minutes a day 7 days a week, before my surgery and begin to take two Flinstone complete vitamins one in the morning and then in the evening. Then after the surgery I am on clear liquids for the first week with nothing but clear,but others get to have things like jello the first week It just seems to me that I am not ask to do to much to prepare for my surgery except the walking and I don't like to walk so that is not easy. Then I am told I will be getting up every two hours around the clock beginning the first day of my surgery. How does one get any rest and recover if you are up walking every two hours round the clock? I know it is to prevent blood clots so I am not complainning I just know me and pain and getting up after being cut open. Anyway was just wondering why certain rules from different doctors. I trust my surgeon totally and know he is good but just wanted to know if anyone knows why the have different requirements?

[DocSanae]

A lot of it comes from the individual experiences of the surgeons themselves. There is a basic set of rules they go by, but a lot is left up to the surgeon to modify to fit their own needs, and what they find comfortable with. Also, what set of instructions they find their patients most cooperative with, too.
For instance, take the 30 minute walking. Your surgeon probably wants you to get in the habit of exercising, and also to strengthen your cardiovascular capacity, which is important for surgery. Aerobic exercise such as walking, jogging, swimming, also helps in reducing visceral fat, the fat within you abdominal cavity. Now, one of the reasons he asks for the walking instead of the liquid diet, may be because, in his experience, he's found that his pre op patients in the past complied better to the walking than the liquid diet.

Another reason is timing. As the number of WLS surgery surges, and the procedures, pre, during, and post op are improved (as is with all medical techiques, everything is always being improved on, daily, so what was the norm a year ago could have gone completely out of style a year later, then someone re-discover and implement new equipments thereby improving the original techinique, etc) the post ops who had their surgery a year, two years, heck, even half a year ago, could have been required to do things differently before today's best menu came up.

I'll have to admit, medical conferences and meetings often make a difference, too, when a dr attends one, we always come back with some new knowledge that others have shared with us, so, we come home and try out the new method to get better results.

Anyway, medicine is an ever evolving and improving science, so, so long as your surgeon knows what he is doing, and is proficient, then, you are in safe hands, even if his sets of requirements are different from others.

[Exhorter]

Thanks Doc that helps. I just have read so many different things. Expecially reguarding the vitamins.... my surgeon said really all I would need is the two Flinstone Vitamins one in the morning one at night and possibly some Vitamin D once the surgery is complete. Also I am hearing that there is lots of blood work required every 6 months for the rest of my life? My surgeon never mentioned that or about anything but the Flinstone everyday. Plus oh how he pushes the walking!!! I do understand that!

[DocSanae]

The necessity of vitamins and minerals as supplements your whole life is now basically known as a must with RNY and other procedures that involve malabsorbtion by rerouting the guts as well as making the stomach size smaller, as opposed to lap banding and sleeve gastrectomy, which only reduces the size. With size reduction, your abporptive route is intact, so you don't have to worry about the vitamins not being absorbed, only that the amount of intake may be less due to the reduced capacity of the amount you can eat. With the malabsorbtive methods, you will lack the area of your gut where most vitamins normally are absorbed, so you need to get in larger amount so they can be absorbed where absorbtion is intact. This is the same with minerals. There actually have been reports where lack of Vitamin A caused temporary blindness in some post ops, as well as anemia coming from lack of VB12 and iron. Depletion of calcium is also another concern, and VD helps in that area.

I would say, just about every surgeon now will require their patients to be dilligent about their supplements, but sometimes, they may not state, nor stress, in the way that particular patient truly understands, as the same language may mean, or be taken differently by different individuals, which isn't a rare occurence. Result:the particular person may say what they think they were told, not what their drs actually said. Most of the people on this board have been told by their surgeons to be dilligent in getting their vitamins in.

You will need life long observation in regards to the levels of your vitamins and other minerals as well, so, immediately post op, you will be asked to check in at least a few times, some even more, during the year following your surgery. The post op visits will be spaced longer apart later on, but be prepared for an annual visit.

The host of this site, CraigT's blood reports came back with anemia a couple of years ago (nothing up till the year before) and he will be 10 years post op in May. He is proof that some things come up years after surgery, and long since you've reached a comfortable spot with living with your pouch.

There is a saying here in Japan that goes, "One illness, healthy life." Meaning, if you have one illness that you need to take care of, you will be careful of your entire health, and as a result be able to live in overall good health, even if you have this one thing. For the WLSers, this "one illness" is should be your pouch.

(((((((((HUGS))))))))

[fr1endly2]

I know my surgeon also has different aged patients see differecnt pre op specialists for their surgery clearance. A younger patient clearly doesnt have to see the same doctors as an older patient.

(thought i would just add that tad bit more on the topic from what i saw at my surgeons offfice)

[chrissyb]

I think Doc gave some you some really good information. I just wanted to say that sugar free jello is considered to be a clear liquid and so are sugar free popsicles. So you'll be able to have them the first week which will help. You won't really be hungry anyway. I just know it's scary to think about having nothing but liquids before surgery but you will be okay when the time comes.

Hugs,
Chrissy

[akosak]

Exhorter,

I have found, that even with a surgery center sometimes the doctors will give different before surgery instruction. They seem to tailer it to the person. When I went to the support group last weekend we talked about this subject and found out that we had all had differnt instrustion. I was told not to gain any weight start excersing, taking iron, and calcium. I was already taking multi vit. Others were told loss 5 to 20 pounds some were told they could only gain 5 pounds before surgery. I really think alot of Dr's try to customize for every person.

[MsVickie]

Reading back....on your post. Are you going to have to have a open surgery? My Dr. told me NPO after midnite. That is nothing to eat or drink buy mouth. However afterwards he likes to do Medifast so Im told. Its not a requirement but he feels the malnutrion is somthing so serious to him he advises it. I think its your Dr and possibly your condition before. And probally the patients themselfs after all the surgerys they have done finding what works best. Yes they have to learn with ya. Scary but good in a way.

[Exhorter]

Thanks everyone for the great info. Chrissy my doc says no popsicles or jello the first week. Not until the drain comes out. But each one does have their own rules. Right now I need to just follow the ones he has given me and that is to walk and take my Flinstones. I have not been doing my walking and I could be in trouble about that if I do not start. So I will begin tomorrow to walk my 30 minutes daily.

[fr1endly2]

YES each surgeon does have there own rules and i never can say enough go by what they say too!!!! THE walking early out will help break up any of the gas in your stomach from the surgery. I know the first weeks there was no way i could walk 30 mintues at once. I had to take many small
walks and only could bet about 3 houses away from mine before i was completely winded. IT was all 90 degress and humid when i first arrived home from my surgery so that didnt help me to much. I just did mini walks early out.